Field of the Invention
After every surgical operation, the healing of the wound has great importance. Attempts have therefore been made to create the optimal preconditions for the most risk-free, painless, and rapid healing. It is known that wounds, the cutting edges of which have been held together by means of clamps or threads, heal more rapidly and cosmetically more attractively than wounds which are allowed to heal by themselves (Williams and Harrison, 1977). In many specialties of medicine, clamping techniques have their fixed place next to suture techniques, particularly in gynecological and abdominal operations. Recently, clamping techniques have again found increasing application in various other fields. These offer many technical and medical advantages in comparison with suture techniques. During their application the rates of infection are lower, granulomas do not arise as frequently, and the average hospital stay of the patient is thus shorter (Beresford et al, 1984). In the case of dermal inflammations, clamping is therefore preferred, because it is much faster than the application of a thread suture. The skin transplant can be placed more rapidly, and the critical anesthesia time can therefore be reduced (Kahn et al, 1984; Hallock et al, 1984 ). Stephens and Niesche (1974) recommend skin clamping for wound closures during abdominal operations, neck operations, breast and thorax operations, and Nockemann (1968) recommends it for skin closures after thyroid operations. According to Swanson (1982), clamping is suited on the scalp, on the face, and on the extremities. Through the traumatization of the tissue, which is reduced in comparison with thread suturing, clamping provides a more attractive healing of the wound and a slighter formation of scars. According to Nockemann (1965/1968), sutures leave scars at the puncture points, as well as at the points where the thread has been laced or compressed with the tissue for a period of time. These scars can be very irritating to the skin, and have unattractive effects. Attempts have therefore been made to keep the size and number of puncture points as small as possible and to entirely avoid lines of scar tissue pressure points, which are caused by the thread, and which produce the known Strickleiter syndrome.
These attempts led to the closure of wounds of the skin by means of clamps. Their application and removal is simple and fast. In addition, the danger of bacterial colonization on the metal of the clamps is slight, since the germs adhere poorly to the smooth surface, and the metal furthermore has its own, germ-killing, bactericidal effect. In contrast to this, the use of suture materials in the wound increases the risk of the virulence of the staphylococci by some 10,000-fold. The abscess rate is about three times less with the clamping technique. According to Stephens (1970), wounds closed with clamps showed, on the 7th post-operative day, better mechanical properties than those closed by means of a suture thread; that is, the coefficient of elasticity is greater, the breaking strength is higher, and the capacity for energy absorption without rupture is better. Lowdon et al (1980) also found that the post-operative complications in the form of anastomosis weakness, wound infections, and hemorrhages were about 25% rarer when using clamps. An experiment by Meiring (et al, 1982) on each of 20 patients also showed, that the wound closure by means of clamping was about 80% faster, and could also be carried out more simply, than was the case with a conventional threaded suture.
These numerous and evident advantages show the fundamental significance of the clamping technique, which has been used in place of suture techniques in most clinics in the USA. Nevertheless, the clamps most commonly used today still have decisive defects, which must be eliminated.